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Southampton Joint Formulary
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 Formulary Chapter 4: Central nervous system - Full Chapter
04.06  Expand sub section  Drugs used in nausea and vertigo
04.06  Expand sub section  Antihistamines
Cinnarizine
(tablet)
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Formulary
Green

For labyrinthine vertigo or acute treatment of Ménière’s disease

 
   
Cyclizine
(tablet / injection)
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Formulary

Green For oral, intramuscular or subcutaneous administration. Note: subcutaneous administration is off label but is established practice in palliative care. 

Red For intravenous administration. Restricted Item Due to safety concerns, intravenous use of cyclizine at UHS is restricted to short-term (i.e. single dose) only.

 
   
Promethazine
(tablet/liquid)
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Formulary
Green

 

  • 10mg, 25mg tablets
  • 5mg/5ml elixir
 
   
04.06  Expand sub section  Phenothiazines and related drugs
Prochlorperazine
(tablet/liquid/injection/buccal tablet)
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Formulary
Green

Buccal tabs are an alternative to injectable antiemetics.

 
   
Levomepromazine
(tablet/injection)
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Formulary
Amber Initiation

Palliative care

 
   
04.06  Expand sub section  Domperidone and metoclopramide
Domperidone
(tablet/liquid/suppositories)
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Formulary
Green

unlicensed unlicensed suppositories. Also used off-label for stimulation of lactation (contra-indicated in patients with known cardiac problems).

Short-term use only. No longer indicated as a motility stimulant.

 
Link  Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents
Link  MHRA Drug Safety Update May 2014: domperidone risk of cardiac side effects
   
Metoclopramide
(tablet/liquid/injection)
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Formulary
Green

Short term use only. No longer indicated as a motility stimulant

 
Link  MHRA Drug Safety Update Aug 2013: metoclopramide risk of neurological adverse effects
   
04.06  Expand sub section  5HT3 antagonists to top
Ondansetron
(tablet/liquid/injection)
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First Choice
Green
 
Granisetron
(tablet/injection)
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Amber Recommended

After ondansetron has failed in children receiving chemotherapy and patients with gastrointestinal failure

 
   
Granisetron (Sancuso® )
(patch)
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Formulary
Red

Restricted Item Specialist use only as per licensed indications

 
   
Netupitant and Palonosetron (Akynzeo®)
(capsule)
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Formulary
Red

For prevention of chemotherapy-induced nausea/vomiting

 
   
04.06  Expand sub section  Neurokinin receptor antagonist
Aprepitant (Emend®)
(capsule/liquid)
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Formulary
Red

For chemotherapy-induced nausea/vomiting

Liquid for chemotherapy-induced nausea/vomiting in children 6months - 12years

 
   
04.06  Expand sub section  Hyoscine
Hyoscine hydrobromide
(tablets/patch/injection)
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Formulary
Amber Recommended

Tablets/patch may also be used off-label for hypersalivation

 
   
04.06  Expand sub section  Other drugs for Ménière's disease
Betahistine Dihydrochloride
(tablets)
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Formulary
Green

For prophylaxis in proven Ménière’s disease

 
   
 ....
 Non Formulary Items
Dolasetron Mesilate  (Anzemet®)

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Non Formulary
 
Doxylamine and pyridoxine  (Xonvea®)
(tabs)

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Non Formulary
Black

DPC do not support use locally (Feb 2019).

Not supported by SMC (May 2019) or AWMSG (June 2019).

Link  NICE Evidence Summary Doxylamine/pyridoxine (Xonvea) for treating nausea and vomiting of pregnancy June 2019
 
Fosaprepitant  (Ivemend®)

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Non Formulary
 
Palonosetron  (Aloxi®)

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Non Formulary
 
Perphenazine

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Non Formulary
 
Tropisetron  (Navoban®)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine

Traffic Light Status Information

Status Description

Green

Suitable for prescribing by all in both primary and secondary care.  

Amber Recommended

Specialist recommended but suitable for continuation in primary care.  

Amber Initiation

Specialist initiated but suitable for continuation in primary care.  

Amber SCG

Specialist initiated and for continuation in primary care under a locally approved shared care guideline.  

Red

Suitable for prescribing in specialist settings (secondary care) only.   

Red Specialist Centre

Secondary care medicines to be used under specialised commissioning arrangements only.  

Blue

For primary care, either via FP10 or supplied through specialist services. These products may be stocked by hospital pharmacies only for supply to primary care units/wards or for continuing supplies for patients admitted on therapy.  

Black

Not recommended for use.  

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